Autoperfusion balloon versus stent for acute or threatened closure during percutaneous transluminal coronary angioplasty

• Published in: The American journal of cardiology Vol. 74; no. 10; pp. 1002 - 1005
• Main Authors: DE MUINCK, E. D, DEN HEIJER, P, VAN DIJK, R. B, CRIJNS, H. J. G. M, HILLEGE, H. J, PE TWISK, S, LIE, K. I
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier 15.11.1994; Elsevier Limited
• Subjects: Aged; Angioplasty; Angioplasty, Balloon, Coronary - adverse effects; Angioplasty, Balloon, Coronary - instrumentation; Biological and medical sciences; Coronary Disease - therapy; Disease-Free Survival; Diseases of the cardiovascular system; Female; Humans; Male; Medical research; Medical sciences; Middle Aged; Myocardial Reperfusion - instrumentation; Prospective Studies; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Recurrence; Stents; Transplants & implants; Human; Endoprosthesis; Coronary artery; Instrumentation therapy; Cuffed tube; Instrumental dilatation; Technique; Comparative study
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/0002-9149(94)90848-6

Efficacy and major clinical end points were compared in 61 patients treated with a Stack autoperfusion balloon versus 36 patients who received a Palmaz-Schatz stent for acute or threatened closure during coronary angioplasty. The groups were comparable regarding baseline clinical characteristics. Procedural success was achieved in 43 patients (70%) treated with an autoperfusion balloon versus 34 patients (94%) who received a stent (p < 0.02). Emergency bypass surgery was performed in 13 patients (21%) with the autoperfusion balloon versus none of the patients with a stent (p < 0.001). In the stent group, 3 patients (8%) died (p < 0.05); 2 deaths were caused by thrombotic reclosure, and 1 patient died after unsuccessful stent delivery. Subacute reclosure during hospitalization occurred in none of the patients with autoperfusion versus 8 patients with the stent (22%) (p < 0.0002). Therefore, the number of patients with successful stent implantation at discharge decreased to 26 (72%). At 3-month follow-up in all patients with a successful intervention, reclosure or angiographic restenosis (> 50%) occurred in 13 patients with autoperfusion (30%) versus 3 patients with stents (12%) (p = NS). There was no difference in event-free survival during follow-up. Thus, both interventions were equally successful in the treatment of acute and threatened closure. More emergency surgery was performed in the autoperfusion balloon group, whereas a higher subacute reclosure rate was seen in the stent group. At 3-month follow-up, there were no significant differences regarding reclosure, restenosis, and event-free survival.